Forms & Insurance Carriers
**Parents please be advised: In accordance with new state mandates, our facility is REQUIRED to obtain your child's social security number and include it in data reports**
**In addition, due to the Coronavirus pandemic, we will be taking some special precautions to minimize any chance of exposure to our patients, families, and staff. Until further notice, only one parent may accompany patient for their elective surgery. No siblings or extended families will be allowed into waiting rooms, pre-op areas, or post-op areas. We apologize for any inconvenience this may cause. Safety is our number one priority.**
Online Clinical History:
Odessa location: One Medical Passport-Odessa
Tampa location: One Medical Passport-Tampa
Pediatric Surgery Centers currently accepts the following insurance plans:
Aetna - All Products
Americhoice
Amerigroup
Avalon
Avmed
Blue Cross Blue Shield of FL - All Products
Cigna & Cigna Great West - All Products
Coventry
Evolutions
First Health
Humana - All Products
Multi-Plan - Excluding "Limited" plans
Medicaid
Medicaid - CMS - Pedi-Care-Title "19" and "21"
Medicaid - Florida Healthy Kids
Medicaid - Humana
Medicaid - Integral
Medicaid - Molina
Medicaid - Prestige
Medicaid - Simply H/C
Medicaid - Sunshine State
Tricare/Prime and Standard
United Healthcare/Golden Rule - All Products
Wellcare/Staywell
Having Surgery in our Odessa Location
Patient Packet - Spanish Patient Packet - English Patient's Communication Preference form
Having Surgery in our Tampa/Brandon Location
Patient Packet - Spanish Patient Packet - English Patient's Communication Preference form
USPI Policies
Terms of Use Social Media Terms of Use PSC Odessa Non Discrimination Form PSC Tampa Non Discrimination Form Translated Nondiscrimination Tagline HIPPA Employee Information Notice Privacy Policy Notice of Privacy Practices-English - Tampa/Odessa Notice of Privacy Practices-Spanish - Tampa/Odessa
Patient Rights
Patient Rights Form Patient Rights Form Spanish Your Rights and Protections Against Surprise Medical Bills
Health Care Power of Attorney
Your Rights and Protections Against Surprise Medical Bills
In order to schedule an appointment for your child’s procedure, you will need to contact your surgeon’s office directly.
Contact our office today